January 2018 1st QTR ASC Drug File
Effective 01.01.2018
| HCPCS Code | Status Indicator | Amount |
|---|---|---|
| A9515 | A | $5,700.00 |
| A9587 | A | $66.74 |
| A9588 | A | $389.55 |
| C9014 | A | $95.40 |
| C9015 | A | $9.96 |
| C9016 | A | $2,826.67 |
| C9024 | A | $186.70 |
| C9028 | A | $2,202.44 |
| C9029 | A | $102.65 |
| C9132 | A | $1.86 |
| C9250 | A | $111.37 |
| C9257 | A | $1.92 |
| C9293 | A | $298.28 |
| C9399 | C | $0.00 |
| C9460 | A | $15.12 |
| C9482 | A | $9.99 |
| C9488 | A | $30.73 |
| C9492 | A | $73.60 |
| C9493 | A | $19.19 |
| C9497 | A | $150.63 |
| J0129 | A | $48.55 |
| J0135 | A | $1,176.93 |
| J0178 | A | $971.95 |
| J0180 | A | $171.41 |
| J0202 | A | $1,812.77 |
| J0207 | A | $974.04 |
| J0220 | A | $159.63 |
| J0221 | A | $159.76 |
| J0256 | A | $4.54 |
| J0257 | A | $4.68 |
| J0287 | A | $14.92 |
| J0289 | A | $20.71 |
| J0300 | A | $234.02 |
| J0400 | A | $0.76 |
| J0401 | A | $5.02 |
| J0470 | A | $51.23 |
| J0475 | A | $177.86 |
| J0476 | A | $42.88 |
| J0480 | A | $3,546.84 |
| J0485 | A | $3.91 |
| J0490 | A | $42.93 |
| J0561 | A | $12.81 |
| J0565 | A | $40.18 |
| J0570 | A | $1,257.11 |
| J0585 | A | $6.13 |
| J0586 | A | $8.24 |
| J0587 | A | $11.99 |
| J0588 | A | $5.08 |
| J0594 | A | $31.40 |
| J0596 | A | $27.98 |
| J0597 | A | $48.91 |
| J0598 | A | $57.17 |
| J0600 | A | $5,588.33 |
| J0606 | A | $3.47 |
| J0630 | A | $2,267.02 |
| J0637 | A | $18.13 |
| J0638 | A | $108.03 |
| J0641 | A | $0.31 |
| J0695 | A | $5.14 |
| J0712 | A | $2.61 |
| J0714 | A | $77.08 |
| J0716 | A | $4,459.02 |
| J0717 | A | $7.93 |
| J0740 | A | $465.88 |
| J0775 | A | $41.83 |
| J0795 | A | $8.61 |
| J0800 | A | $3,764.28 |
| J0840 | A | $3,002.00 |
| J0850 | A | $1,129.13 |
| J0875 | A | $14.77 |
| J0878 | A | $0.50 |
| J0881 | A | $3.90 |
| J0882 | A | $3.90 |
| J0883 | A | $1.50 |
| J0884 | A | $1.50 |
| J0885 | A | $12.13 |
| J0888 | A | $1.63 |
| J0894 | A | $16.13 |
| J0897 | A | $17.75 |
| J1110 | A | $104.77 |
| J1130 | A | $0.18 |
| J1162 | A | $3,421.59 |
| J1190 | A | $223.22 |
| J1212 | A | $554.57 |
| J1290 | A | $452.11 |
| J1300 | A | $228.37 |
| J1322 | A | $230.92 |
| J1327 | A | $20.49 |
| J1364 | A | $72.36 |
| J1410 | A | $301.72 |
| J1428 | A | $169.27 |
| J1430 | A | $444.10 |
| J1438 | A | $588.57 |
| J1439 | A | $1.05 |
| J1442 | A | $1.00 |
| J1447 | A | $0.61 |
| J1451 | A | $7.55 |
| J1453 | A | $2.05 |
| J1455 | A | $75.17 |
| J1458 | A | $380.47 |
| J1459 | A | $38.48 |
| J1460 | A | $32.96 |
| J1555 | A | $13.79 |
| J1556 | A | $70.52 |
| J1557 | A | $40.03 |
| J1559 | A | $9.83 |
| J1560 | A | $329.58 |
| J1561 | A | $40.70 |
| J1566 | A | $34.42 |
| J1568 | A | $35.59 |
| J1569 | A | $40.72 |
| J1571 | A | $63.17 |
| J1572 | A | $33.65 |
| J1573 | A | $63.17 |
| J1575 | A | $14.06 |
| J1595 | A | $211.72 |
| J1602 | A | $24.28 |
| J1610 | A | $219.14 |
| J1627 | A | $4.60 |
| J1640 | A | $22.36 |
| J1670 | A | $485.60 |
| J1726 | A | $27.61 |
| J1740 | A | $84.89 |
| J1742 | A | $200.05 |
| J1743 | A | $542.86 |
| J1744 | A | $351.82 |
| J1745 | A | $85.81 |
| J1750 | A | $13.04 |
| J1786 | A | $41.70 |
| J1826 | A | $604.40 |
| J1830 | A | $379.76 |
| J1833 | A | $0.69 |
| J1930 | A | $56.69 |
| J1931 | A | $30.61 |
| J1942 | A | $2.43 |
| J1950 | A | $1,087.45 |
| J2182 | A | $28.84 |
| J2265 | A | $1.59 |
| J2278 | A | $7.44 |
| J2315 | A | $3.25 |
| J2320 | A | $72.58 |
| J2323 | A | $19.42 |
| J2325 | A | $73.32 |
| J2326 | A | $1,103.29 |
| J2350 | A | $57.08 |
| J2353 | A | $190.68 |
| J2355 | A | $467.22 |
| J2357 | A | $34.94 |
| J2407 | A | $23.24 |
| J2425 | A | $19.09 |
| J2426 | A | $10.37 |
| J2469 | A | $20.30 |
| J2502 | A | $272.32 |
| J2503 | A | $721.25 |
| J2504 | A | $358.99 |
| J2505 | A | $4,442.31 |
| J2507 | A | $2,060.48 |
| J2515 | A | $51.19 |
| J2547 | A | $1.68 |
| J2562 | A | $314.44 |
| J2597 | A | $12.90 |
| J2724 | A | $15.16 |
| J2760 | A | $389.08 |
| J2770 | A | $418.20 |
| J2778 | A | $386.55 |
| J2783 | A | $263.51 |
| J2786 | A | $9.11 |
| J2792 | A | $25.31 |
| J2793 | A | $24.09 |
| J2794 | A | $8.96 |
| J2796 | A | $68.06 |
| J2820 | A | $37.79 |
| J2840 | A | $530.00 |
| J2850 | A | $34.78 |
| J2860 | A | $92.73 |
| J2941 | A | $74.65 |
| J2993 | A | $2,301.91 |
| J2997 | A | $84.95 |
| J3060 | A | $40.38 |
| J3070 | A | $66.37 |
| J3090 | A | $1.37 |
| J3095 | A | $5.38 |
| J3101 | A | $111.55 |
| J3145 | A | $1.29 |
| J3240 | A | $1,602.64 |
| J3243 | A | $2.82 |
| J3246 | A | $9.10 |
| J3262 | A | $4.53 |
| J3285 | A | $61.24 |
| J3300 | A | $3.87 |
| J3315 | A | $415.78 |
| J3357 | A | $187.12 |
| J3358 | A | $12.85 |
| J3380 | A | $18.56 |
| J3385 | A | $343.93 |
| J3396 | A | $10.76 |
| J3465 | A | $2.24 |
| J7175 | A | $6.84 |
| J7178 | A | $1.17 |
| J7179 | A | $2.28 |
| J7180 | A | $8.22 |
| J7181 | A | $15.09 |
| J7182 | A | $1.26 |
| J7183 | A | $1.03 |
| J7185 | A | $1.28 |
| J7186 | A | $0.98 |
| J7187 | A | $1.10 |
| J7188 | A | $2.82 |
| J7189 | A | $1.99 |
| J7190 | A | $1.08 |
| J7192 | A | $1.28 |
| J7193 | A | $1.15 |
| J7194 | A | $1.41 |
| J7195 | A | $1.51 |
| J7197 | A | $3.73 |
| J7198 | A | $2.00 |
| J7200 | A | $1.38 |
| J7201 | A | $3.00 |
| J7202 | A | $4.16 |
| J7205 | A | $2.02 |
| J7207 | A | $1.78 |
| J7209 | A | $1.63 |
| J7210 | A | $1.42 |
| J7211 | A | $1.25 |
| J7308 | A | $404.59 |
| J7311 | A | $20,100.17 |
| J7312 | A | $200.56 |
| J7313 | A | $490.48 |
| J7316 | A | $1,046.80 |
| J7320 | A | $6.42 |
| J7321 | A | $85.21 |
| J7322 | A | $19.26 |
| J7323 | A | $155.23 |
| J7324 | A | $140.11 |
| J7325 | A | $12.26 |
| J7326 | A | $521.57 |
| J7327 | A | $846.76 |
| J7328 | A | $2.18 |
| J7336 | A | $3.16 |
| J7340 | A | $2.14 |
| J7342 | A | $29.97 |
| J7345 | A | $1.40 |
| J7501 | A | $235.16 |
| J7503 | A | $1.23 |
| J7504 | A | $1,942.78 |
| J7505 | A | $6.80 |
| J7511 | A | $712.20 |
| J7525 | A | $187.83 |
| J8501 | A | $6.68 |
| J8560 | A | $73.78 |
| J8655 | A | $398.83 |
| J8670 | A | $2.26 |
| J8705 | A | $103.68 |
| J9015 | A | $3,598.38 |
| J9017 | A | $71.05 |
| J9019 | A | $402.74 |
| J9022 | A | $75.79 |
| J9023 | A | $79.37 |
| J9025 | A | $1.58 |
| J9027 | A | $145.45 |
| J9031 | A | $132.79 |
| J9032 | A | $36.11 |
| J9033 | A | $30.13 |
| J9034 | A | $23.66 |
| J9035 | A | $76.66 |
| J9039 | A | $107.74 |
| J9041 | A | $46.95 |
| J9042 | A | $144.96 |
| J9043 | A | $159.14 |
| J9047 | A | $33.18 |
| J9050 | A | $3,852.78 |
| J9055 | A | $59.22 |
| J9065 | A | $21.18 |
| J9070 | A | $42.27 |
| J9098 | A | $628.90 |
| J9120 | A | $1,404.01 |
| J9145 | A | $49.50 |
| J9150 | A | $43.57 |
| J9155 | A | $3.64 |
| J9171 | A | $1.74 |
| J9176 | A | $6.35 |
| J9179 | A | $110.57 |
| J9185 | A | $84.69 |
| J9202 | A | $375.69 |
| J9203 | A | $193.16 |
| J9205 | A | $42.92 |
| J9207 | A | $73.00 |
| J9211 | A | $43.40 |
| J9214 | A | $31.49 |
| J9216 | A | $6,308.13 |
| J9217 | A | $211.20 |
| J9218 | A | $26.63 |
| J9225 | A | $3,286.03 |
| J9226 | A | $28,976.68 |
| J9228 | A | $146.69 |
| J9230 | A | $292.48 |
| J9245 | A | $1,193.00 |
| J9261 | A | $151.91 |
| J9262 | A | $2.84 |
| J9264 | A | $11.03 |
| J9266 | A | $14,342.07 |
| J9268 | A | $1,977.98 |
| J9271 | A | $47.87 |
| J9280 | A | $140.81 |
| J9285 | A | $49.95 |
| J9293 | A | $32.04 |
| J9295 | A | $5.37 |
| J9299 | A | $26.79 |
| J9301 | A | $60.64 |
| J9302 | A | $56.47 |
| J9303 | A | $111.39 |
| J9305 | A | $66.31 |
| J9306 | A | $11.43 |
| J9307 | A | $257.11 |
| J9308 | A | $57.03 |
| J9310 | A | $877.83 |
| J9315 | A | $329.21 |
| J9320 | A | $336.70 |
| J9325 | A | $48.27 |
| J9328 | A | $9.56 |
| J9330 | A | $71.69 |
| J9340 | A | $749.91 |
| J9352 | A | $290.64 |
| J9354 | A | $30.21 |
| J9355 | A | $100.65 |
| J9357 | A | $1,198.32 |
| J9371 | A | $2,701.78 |
| J9395 | A | $96.88 |
| J9400 | A | $8.10 |
| J9600 | A | $21,219.57 |
| P9041 | A | $11.80 |
| P9045 | A | $54.72 |
| P9046 | A | $22.49 |
| P9047 | A | $53.44 |
| Q0138 | A | $0.93 |
| Q0139 | A | $0.93 |
| Q2009 | A | $3.91 |
| Q2017 | A | $2,463.92 |
| Q2043 | A | $39,924.06 |
| Q2049 | A | $508.43 |
| Q2050 | A | $385.77 |
| Q3027 | A | $50.17 |
| Q5101 | A | $0.69 |
| Q5102 | A | $75.52 |
| Q9968 | A | $3.92 |
| Q9982 | A | $3,498.00 |
| Q9983 | A | $2,968.00 |
| 90371 | A | $116.00 |
| 90375 | A | $302.47 |
| 90376 | A | $332.43 |
| 90378 | A | $1,514.17 |
| 90396 | A | $1,357.03 |
| 90675 | A | $284.98 |
| 90676 | A | $196.54 |
| 90740 | C | $0.00 |
| 90743 | C | $0.00 |
| 90744 | C | $0.00 |
| 90746 | C | $0.00 |
| 90747 | C | $0.00 |
All CPT codes begin with a numeric character and all HCPCS codes begin with an alpha character.
All Current Procedural Terminology (CPT) codes and descriptors are copyrighted 2018 by theĀ American Medical Association.

